Physical Therapy

What You Need to Know: Plantar Fasciitis

Today’s blog post is courtesy of a special guest writer and expert on the topic of Plantar Fasciitis: Rachel Zimmerman DPT.

If you’ve ever experienced pain in the bottom of your foot, or in your heel, chances are it’s Plantar Fasciitis.

There is a common misconception that this is something you have to live with, but you don’t! The following advice will help alleviate your pain and get you back on your feet.

What is Plantar Fasciitis?

To understand what this condition is, we need to break it down into parts: plantar fascia and -itis. The plantar fascia is a structure in the bottom of the foot. It is a thin, white tissue similar to a ligament that sits between the skin and the muscle and extends from the heel to the toes. It provides stability to the foot. The suffix “-itis” is a Greek term meaning inflammation. So plantar fasciitis is inflammation of this tissue in the bottom of the foot.

What are the Symptoms of Plantar Fasciitis?

Plantar fasciitis typically presents as pain in the heel, usually on the inside part of the foot. The pain can also spread along the arch and along the bottom of the foot. The pain is usually worst during the first few steps after getting out of bed in the morning but can also occur after standing or walking for long periods of time.

What Causes Plantar Fasciitis?

Plantar fasciitis has multiple causes, but one of the most common is increasing your activity level too quickly! Also, having tight calf muscles, weak foot muscles, and/or wearing improper footwear.

What do I do if I believe I have plantar fasciitis?

Avoid aggravating activities: The most important thing you can do when you have an inflammatory condition is to avoid activities that increase your pain. Figure out which activities are aggravating it and modify them as you can. This does not mean to avoid activity altogether – just find activities you can do that don’t increase your pain level. This does not have to be long term, just while you are experiencing pain.

Stretch your calves: Tight calf muscles (the gastrocnemius and soleus muscles) can contribute to inflammation in the plantar fascia. Stretch your calves by sitting with your feet out in front of you with your knees straight, and place a towel around the ball of your foot. Pull back on the towel towards you until you feel a stretch in the calf. Hold for 30 seconds and then repeat a few times. You should feel a stretch, but not pain.

Strengthen your foot muscles: There are specific muscles in your foot that help to support your arch and take stress off the plantar fascia.

   • Great toe extension: Lift big toe, leaving other 4 on the ground. Repeat for 3 sets of 10.

   • Small toe extension: Lift 4 smaller toes, leaving big toe down. Repeat for 3 sets of 10.

   • Doming: Raise the arch of your foot, keeping toes down. Repeat for 3 sets of 10.

Change your footwear: Avoid shoes that are flat as these do not support your arch and can contribute to stress on the plantar fascia. Look for shoes that have a buildup on the inside of the shoe where your arch would be. Most shoe stores will be able to help find footwear that is appropriate for your feet, whether you need a stability shoe (which has more arch support than normal) or a neutral shoe (which has arch support but not as much as a stability shoe).

Ice: You can freeze a plastic water bottle, and then roll your bare foot over the frozen water bottle. It provides massage and ice, which will decrease the inflammation and will numb the pain temporarily. Do this for a few minutes at a time at most.

Consider orthotics: There are orthotics, or inserts for your shoe, that provide more stability for your arch. You can try basic orthotics from a drugstore or consider custom orthotics. A physical therapist, podiatrist, or orthotist can help you with custom orthotics.

**If your pain does not get better, consult a physical therapist! There are many other factors that contribute to plantar fasciitis that your physical therapist may be able to assess and treat.

This blog was specially written by our friend and guest writer Rachel Zimmerman, DPT.

Rachel is clinic director at ATI Physical Therapy right here in Green Bay, WI. You can find out more about her clinic or find a location near you at ATIpt.com!

Stress Incontinence? Don’t Worry. Pee Happy!

Have you ever experienced urine leakage while exercising or even coughing?  Do you think it only happens to mothers or females in general?

We are so lucky to have an Ellipse Fitness super hero member whose alter-ego is an expert on the pelvic floor. Veronica Lane, MHS, PT works with women all the time to strengthen their pelvic floor and stop the evil villain, we call, Stress Incontinence in its tracks.

Veronica noticed women heading off to the restroom during activities such as jumping jacks. Some members would joke, “darn kids,” and some coaches who empathize, “happens all the time.”

Lane says, “Yes.  It is common, but it doesn’t have to be tolerated, accepted, or considered a new normal.” Leaking, or incontinence, is not a hopeless result of vaginal births. Similarly, getting up in the middle of the night, at any age, can be resolved.

First, what is the pelvic floor and what does it do?

Confused emoticon

These are the muscles that control urinary and fecal continence.  Strong pelvic floor muscles help to lift the bladder higher in the pelvic cavity, stop the flow of urine, and, along with the anal sphincter, control gas and stool. Poor muscle function can lead to problems with prolapse!

Functions of the Pelvic Floor include

  • Support
  • Sphinteric
  • Sexual
  • Stability

The pelvic floor is part of the core and works with the abdominal cylinder. These muscles need to be able to relax and contract. It is important to build your pelvic floor muscles to support other muscles of the torso.

Stress incontinence is the most diagnosed type of incontinence.  This often occurs when laughing, sneezing, coughing, and participating in physical activity. These activities are directly related to abdominal muscles more commonly referred to when trying to build a six pack.

Do I have to have surgery?

There are some procedures that should be discussed with your doctor. Of course, there are several methods of relief to try in advance of surgery. Lane suggests physical therapy for incontinence, prolapse, frequency, etc. “Conservative treatment should always be the first option!  Also, I still see many women following procedures such as bladder slings. The procedure may fix one problem, but cause another, or maybe it helped the problem(s) without complete resolution.”

Reduce Bladder Irritants

Alcohol*Beer/Wine              Carbonated Drinks*             Caffeine*

*evidence-based

Coffee/Tea (decaf & reg)

Citrus Fruits/Juices             Tomatoes

Spicy Foods                             Sweets                                    Chocolate

Dairy Products                                                                         Artificial Sweeteners

Top 10 Activities  to Increase Bladder Fitness

  1. Go to the bathroom every 3-4 hours or 5-7x in 24 hours
  1. Go for 8 Mississippi’s
  • A full bladder typically takes this long to empty. This can help individuals to determine how full their bladder is when the sensation to go
  1. SIT on the toilet
  • Don’t hover. Yeah. Easier said than done in many public situations!
  1. Go before and after sex
  • Voiding before and after sex is part of the contracting and relaxing process, as well as the cleansing process.
  1. Avoid using the wrong pads
  • Use pads specifically for incontinence. Others can irritate the vagina when worn regularly.
  1. Abdominal strength
  • Participate in exercises that strengthen your abdominal muscles. Try diaphragmatic breathing through a straw, single-leg lowers, and hollow body holds.
  1. Drink plenty of water.
  1. Kegal
  • Correctly! Completely contract. Completely relax. Avoid just squeezing over and over.
  1. Orgasm
  • We will leave the “how” that gets done up to you!
  1. NO “Just in case” urinating, aka JIC-ing. Not even in the middle of the night!

Just In Case Peeing or JIC-ing

JICing pronounce /JIK-ing/ is “just in case” urination. This practice is often supported by society in many ways.  We teach our children from a very early age to go JUST IN CASE before leaving the house, during school, or prior to a sports activity.

JICing trains the bladder to empty before it is full.  JICing regularly will increase the need to go at the first sensation recognized by the bladder. Sometimes that sensation will be laughing, coughing, sneezing, jumping, bracing the abdominal muscles in general, or even riding on a bumpy road.  Ever scurry off to the restroom during a workout because of a strong urge to “GO” yet only to have a few drops?  That is the result of chronic JICing.

The duration between trips to the restroom will also shorten. For example, many people get up in the middle of the night several times to empty the bladder.  Try to avoid going at the first sensation.  Breath and relax to see if the urge passes.  Sometimes habits are so deeply rooted, waking up seems to be normal. This may create some nights of poor sleep.  If we can play the long game, sleep hygiene will only improve.

Lane stresses, “I see a major issue, not as much with weak pelvic floor muscles, but we never ‘let them go’ or relax.  This is common when we have leakage, go too often, and/or have pelvic pain.  Think of bicep muscle.  If we always had our elbows bent and biceps contracted, not relaxed, we would not be able to pick up a gallon of milk.  The biceps would fail.  The same scenario occurs with PF muscles.  If we never let them relax for fear of leaking, going way too often, etc. these muscles will fail when it is time to stop leakage.

We would suggest eliminating just one bladder irritant and adding just one action item in the beginning.  Practice makes permanent. Be patient. Practice. Pee happy!